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KMID : 0942820100090020080
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Journal of Korean Brain Tumor Society
2010 Volume.9 No. 2 p.80 ~ p.87
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Multi-Session Cyberknife Surgery for Parasellar Tumors Adjacent to the Optic Apparatus-A Preliminary Study
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Kim Ji-Yong
Choi Sang-Hyun
Huh Hyun-Do
Kim Eun-Young
Yoon Seung-Hwan
Park Hyeon-Seon
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Abstract
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Objective: Multi-session Cyberknife surgery has been known to be a good alternative for the management of parasellar tumors adjacent to the optic apparatus. In order to apply it more broadly and safely, the exact dosage of optic apparatus tolerance should be determined. We performed this study to determine the safe multi-session schedule for the treatment of these lesions.
Materials and Methods: 9 patients with pituitary adenoma(n=2), metastatic brain tumor(n=2), meningioma(n=2), craniopharyngioma(n=1) and nasal cavity cancer(n=1), situated within 3 mm of the optic apparatus underwent multi-session Cyberknife surgery. Cyberknife radiosurgery was delivered between 4 and 6 sessions, and the cumulative average marginal dose ranged from 2,400 cGy to 3,500 cGy. Contouring and volume measurement of the optic apparatus was based on magnetic resonant imaging(MRI). We measured the cumulative dosage applied on the optic apparatus. Formal visual assessment or clinical examinations were performed before treatment, and about twelve month post-treatment.
Results: The cumulative maximum dosage applied to the optic apparatus was under about 2,500 cGy in all patients. Single maximal dose had been kept below about 500 cGy. There were no acute complications. Visual functions remained unchanged in 5 cases, and improved in 4 twelve months following treatment.
Conclusion: Multi-session Cyberknife surgery for parasellar tumors adjacent to the optic apparatus seemed to be safe if the cumulative maximum dosage was kept below 2,500 cGy, and single session dose below 500 cGy.
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KEYWORD
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Cyberknife, Optic nerve, Optic chiasm, Radiosurgery
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